Transpedicular Screw fixation and Harrington distraction rod are effective means of managing unstable thoracolumbar fracture and fracture dislocation. The authors analysed the 52patients who were treated with above 2methods from March 1986 to February 1993. The results were as follows: 1. Most of patients were in 5th decade compare to younger group and most common cause of injury was fall down, but traffic accident is increasing. 2. The most commonly involved sites were T12and L1 vertebrae and most common type of injury is bursting fracture. 3. Postoperative anterior and posterior column of vertebrae body correction rate were 35.0%/34.4% in ISF group and 29.3%/27.9% in Harrington group. Postoperative correction loss rate were 0.13/0.04 in ISF group and 0.06/0.04 in Harrington group. 4. Postoperative correction of kyphosis angle were average 18 in ISF goup and average 15° in Harrington group. Loss of correction angle was average 23° in ISF group and average 4.4° in Harrington group. 5. Range of spinal fixation was average 3.1 segments in ISF group and average 6.2 segments in Harrington group. 6. There was no significant difference in neurologic recovery between ISF group and Harrington group. The patients who had been recovered neurologically more than 1 grade were 28.6% in Harrington group and 29.2% in ISF group. 7. ISF has some benefit in spnal vertebral body height correction and in maintenance of correction compare to Harrington group. Nevertheless disadvantages of ISF group such as long operative time and possibility of cord compression by pedicular screw, ISF has advantages of almost anatomical reduction and the least spinal fusion.
Accidents, Traffic ; Body Height ; Dislocations ; Humans ; Kyphosis ; Operative Time ; Spinal Fusion ; Spine

PURPOSE: The efficacy of continuous bladder irrigation with amphotericin B versus oral administration of fluconazole(Diflucan ) was compared in the treatment of patients with candiduria. . MATERIALS AND METHODS: A prospective and comparative study of candiduriawas done on 28 patients(Amphotericin B: 13, Fluconazole: 15). Continuous bladder irrigation with 50mg amphotericin B/iota sterile water infused during 24 hours for 2 days was compared to oral administration of 50-100mg/day fluconazole for a range of 7-14 days. Urine culture were obtained 3days, 7 days after continuous bladder irrigation with amphotericin B and 7 days, 14 days after oral administration of fluconazole. RESULTS: The organism was eradicated in 10 patients(76.9%) who received continuous irrigation of amphotericin B and 11 patients(73.3%) who received oral fluconazole therapy. So, There was no statistically significant difference between continuous bladder irrigation with Amphotericin B group and oral medication of fluconazole group(p>0.05). CONCLUSIONS: There was no difference in the cure rate of candiduria between continuous bladder irrigation with Amphotericin B group and oral medication of fluconazole group. So, patient's condition(Foley catheterization, possibility of ambulation and oral feeding) and convinience will be the important deciding factors to select adequate treatment method of candiduria.
Administration, Oral* ; Amphotericin B* ; Catheterization ; Catheters ; Fluconazole* ; Humans ; Prospective Studies ; Urinary Bladder* ; Walking ; Water

Penetrating injuries to the upper cervical spine resulting from gunshots are rare in South Korea due to restrictions of gun use. Moreover, gunshot wounds to the upper cervical spine without neurological deficits occur infrequently because of the anatomic location and surrounding essential structures. We present an uncommon case involving the surgical removal of a bullet located in the anterior arch of first cervical vertebra (C1) via a transoral approach without neurological complications or subsequent mechanical instability.
Republic of Korea ; Spine ; Wounds, Gunshot

BACKGROUND: With respect to the risk of developing diabetic vascular complications, the central purpose of most screening and detection program, is to identify people with diabetes at early stage so they might have advantages of early treatment to prevent complication of the disease. Oral glucose tolerence test(OGTT) is widely used for diagnosis of diabetes and impaired glucose tolerence, bit the performance of a complete OGTT is not only time consuming and expensive but physically demanding on the individual being tested. Determination of HbA1 and more recently of glycosylated total serum proteins(fructosamine) has been proposed as an alternative method of screening and diagnosis. The aim of our cross-sectional study is to compare the values of fructosamine and HbA1, for the ourpose of diabetes diagnosis with the OGTT as reference method. METHODS: In the study, from January 1996 to August 1996, we included 55 consecutive subjects in Kyeungssang Hospital. Blood samples for HbA1 and fructosamone determination were drawn at the same time as a fasting plasma glucose sample, and then all subjects underwent a standard 2-hour OGTT according to the World Health Organization recom-mandations, The subjects were classified according to the American Diabetes Association classification. RESULTS: In our study, we observed fasting plasma glucose of 145.32+/-75.00mg/deciliter, two-hour plasma glucose of 245.83+/-155.22mg/deciliter, HbA1 of 7.06+/-2.77%, and fructosamine of 308.77+/-128.23 micromol/liter. The correlation coefficient between FPG and HbA1 was 0.9098(p<.05), between FPG and fructosamine 0.7953(p Blood Glucose ; Classification ; Cross-Sectional Studies ; Diabetic Angiopathies ; Diagnosis* ; Diagnostic Tests, Routine ; Fasting ; Fructosamine* ; Glucose ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated* ; Mass Screening ; ROC Curve ; World Health Organization

Twenty five consecutive patients requiring reoperation due to hemorrhage following surgery for intracranial hematoma removal were identified in a retrospective review of 211 cases of traumatic intracranial lesions treated at our hospital between January 1990 and December 1994. In cases involving head injury, reoperation is nowadays not uncommon. The incidence of cases requiring reoperation was 11.8%, while delayed or recurrent lesions were more common among older patients(mean age=44.39 years). Acute subdural hemorrhage was the most common initial lesion requiring reoperation: in intracerebral and acute subdural hemorrhage, the incidence of reoperation was relatively high(23.1% and 14.7%, respectively): acute epidural hemorrhage was next most common(8.8%). In 88.0% of cases, reoperation was performed within 24 hours. At the time of discharge, good recovery was reported in five cases(20.0%), moderate disability in ten(40.0%), severe disability in two(8.0%), vegetative state in two(8.0%) and death in six(24.0%). The outcome seems to be related to lesions requiring reoperation rather than initial lesions. Furthermore, closed observation and aggressive management can rapidly improve the outcome, even in patients requiring reoperation: it is, in addition, of the utmost importance that CT scans be used early and repeatedly, especially in patients who are at risk of delayed or recurrent lesions.
Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Incidence ; Intracranial Hemorrhage, Traumatic* ; Intracranial Hemorrhages* ; Persistent Vegetative State ; Postoperative Hemorrhage ; Reoperation* ; Retrospective Studies ; Tomography, X-Ray Computed

Anomalies of the lumbosacral nerve roots, in which conjoined nerve roots are most common, are occasionally accompanied by herniated nucleus pulposus. Most of these anomalies were incidental findings from operations, and recent advances in diagnostic imaging techniques have increased the number of cases of lumbosacral root anomalies reported. All these anomalies are congenital, unilateral and almost exclusively situated at the L5-S1 segment. Diagnostic techniques, such as myelography, CT and MRI detect conjoined nerve root. Conjoined nerve root may be confused with a dumbbell tumor or extruded free disc fragment on CT scans. Surrounded by high-signal intensity epidural fat, a conjoined nerve root is more clearly depicted on MR images than on CT scans. Although the size of disc herniation was small, the symptom was magnified by a relatively fixed conjoined root. At surgery, it is necessary for a larger surgical exposure by means of hemi-laminectomy because of the fixation of the nerve roots, and difficulty in retraction. Recently, we experienced two cases of conjoined nerve root and presented them with a review of the literature.
Diagnostic Imaging ; Incidental Findings ; Magnetic Resonance Imaging ; Myelography ; Tomography, X-Ray Computed

PURPOSE: Both benign prostate hyperplasia(BPH) and male pattern baldness (androgenic alopecia) share the pathogenesis of androgen dependent disorder in addition to afflict large population of old men with chronobiological progress. However, it is unclear that both diseases relate to each other on epidemiologic basis. We evaluated the frequency and severity of male pattern baldness between the patients with BPH and control group. MATERIALS AND METHODS: A total of 225 patients with BPH(mean age: 69.3+/-6.5years) and 160 controls(mean age: 68.5+/-6.4 years), whose age over 60, was included in this study. The estimation of bladness severity was based on the Norwood's classification(grade 1 to VII). International prostate symptom score (IPSS) and genetic tendency of baldness were also evaluated. The difference of IPSS and grade of baldness between two groups were analysed by Mann-whitney test and the frequency of inherited baldness were compared by Chisquare test. Correlations between severity of baldness and IPSS of each group were estimated by Spearman's rank correlation method. RESULTS: It was noted that the patients with BPH had an apparent higher grade of male pattern baldness in comparison with that of controls(median value of IV to 111, p<0.001). The proportion of male pattern baldness with grade IV or greater in BPH group was significantly larger than that of controls(53.8% versus 36.9%, p<0.01). There was greater frequency of inheritant baldness in BPH group than in controls(31.6% versus 12.5%, p<0.001). No significant correlations were noted between baldness severity and IPSS in both groups. CONCLUSIONS: Our study demonstrated there was a strong association of BPH with male pattern baldness.
Alopecia* ; Humans ; Hyperplasia* ; Male* ; Prostate*

Intraarticular ganglion of the knee joint is a cystic mass found around cruciate ligaments in infrapatellar fat pad or under patellar tendon. The first report on intraarticular ganglion of the knee joint along with some intermittent case reports or ganglion around the cruciate ligaments were in 1924 by Caan. Ganglion under the patellar tendon or in the patellar fat pad was first reported in 1972 by Muckle and Monahan. The two cases were treated with open arthotomy and mass excision. There was been no report on ganglion under patellar tendon since then. We managed two cases of ganglion under the patellar tendon with arthroscopic debridement. After 16 months of treatment, there has no recurrence of symptom. We report two cases of ganglion under patellar tendon with the review of the literature.
Adipose Tissue ; Debridement ; Ganglion Cysts* ; Knee Joint ; Ligaments ; Patellar Ligament* ; Recurrence

Anthracyclines have been widely used in cancer therapy because of their efficacy in the treatment of various solid tumors and hem -atologic malignancy. Cumulative dose-related cardiotoxicity was a well-known toxicity of anthracyclines. Particularly, at total doses of more than 550 mg/m2, therapy with anthracyclines could produce irreversible cardiac injury. Anthracycline-induced cardiac toxicity was usually manifested by congestive heart failure or arrhythmia. In co- ntrast, acute myocardial infarction is a rare event of anthracycline-induced heart diseases. A 31-year-old man with non-Hodgkin lymphoma(NHL) and single cardiac risk factor, including smoking, was presented with chest pain after receiving 2nd CEOP-BLAM chemo-therapy. An electrocardiogram revealed ST segment elevation in inferior leads consistent with acute myocardial infarction. An echocardiogram revealed an ejection fraction of 60% and severe hypokinesia in inferior and anteroseptal wall. Three days later, coronary angiography revealed 50% of luminal stenosis of right coronary artery(RCA) and near total occlusion with large thrombi in m-RCA. After balloon angioplasty and stent insertion, the patient was transferred to coronary care unit and continuous intravenous heparin infusion was started. On the 10th days, the patient was discharged in good condition. Six months later, follow-up coronary angiography showed no significant lesion in right coronary artery. In a young man with NHL, we report an acute myocardial infarction after 2nd course of CEOP-BLAM chemotherapy with a review of relevant literatures.
Adult ; Angioplasty, Balloon ; Anthracyclines ; Arrhythmias, Cardiac ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Care Units ; Coronary Vessels ; Doxorubicin* ; Drug Therapy* ; Electrocardiography ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Heparin ; Humans ; Hypokinesia ; Lymphoma, Non-Hodgkin* ; Myocardial Infarction* ; Phenobarbital ; Risk Factors ; Smoke ; Smoking ; Stents

Anthracyclines have been widely used in cancer therapy because of their efficacy in the treatment of various solid tumors and hem -atologic malignancy. Cumulative dose-related cardiotoxicity was a well-known toxicity of anthracyclines. Particularly, at total doses of more than 550 mg/m2, therapy with anthracyclines could produce irreversible cardiac injury. Anthracycline-induced cardiac toxicity was usually manifested by congestive heart failure or arrhythmia. In co- ntrast, acute myocardial infarction is a rare event of anthracycline-induced heart diseases. A 31-year-old man with non-Hodgkin lymphoma(NHL) and single cardiac risk factor, including smoking, was presented with chest pain after receiving 2nd CEOP-BLAM chemo-therapy. An electrocardiogram revealed ST segment elevation in inferior leads consistent with acute myocardial infarction. An echocardiogram revealed an ejection fraction of 60% and severe hypokinesia in inferior and anteroseptal wall. Three days later, coronary angiography revealed 50% of luminal stenosis of right coronary artery(RCA) and near total occlusion with large thrombi in m-RCA. After balloon angioplasty and stent insertion, the patient was transferred to coronary care unit and continuous intravenous heparin infusion was started. On the 10th days, the patient was discharged in good condition. Six months later, follow-up coronary angiography showed no significant lesion in right coronary artery. In a young man with NHL, we report an acute myocardial infarction after 2nd course of CEOP-BLAM chemotherapy with a review of relevant literatures.
Adult ; Angioplasty, Balloon ; Anthracyclines ; Arrhythmias, Cardiac ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Care Units ; Coronary Vessels ; Doxorubicin* ; Drug Therapy* ; Electrocardiography ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Heparin ; Humans ; Hypokinesia ; Lymphoma, Non-Hodgkin* ; Myocardial Infarction* ; Phenobarbital ; Risk Factors ; Smoke ; Smoking ; Stents